ABSTRACT
Sleep-related breathing disorders occur due to the effects of sleep on the central nervous respiratory control system and/or on upper airway (UA) patency. Sleep can thus initiate periods of hypoventilation in individuals already afflicted by disturbances of their ventilatory mechanics such as those suffering from chronic obstructive pulmonary disease, restrictive lung disease, neuromuscular disorders, and morbid obesity. Sleep can also be associated with respiratory instability which, in turn, can translate into the occurrence of respiratory disorders of central origin such as seen in patients with Cheyne–Stokes respiration. Finally, the occurrence of partial or complete UA obstruction during sleep characterizes the obstructive sleep apnea (OSA)/hypopnea syndrome. Interestingly, these various sleep-related breathing disorders can occur jointly, depending on the nature of the underlying disease process (obesity, restrictive thoracic disease, myopathy, and left-sided heart failure) that may be present. Proper understanding of all these patterns of sleep-breathing disorders is essential if one wants to initiate and implement the proper and personalized management.
